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In vitro anti-inflammatory effects of vitamin D supplementation may be blurred in hemodialysis patients

  • Gregório, Paulo C.1
  • Bucharles, Sergio2
  • da Cunha, Regiane S.1
  • Braga, Tárcio1
  • Almeida, Ana Clara3
  • Henneberg, Railson4
  • Stinghen, Andréa E.M.1
  • Barreto, Fellype C.2
  • 1 Laboratorio de Nefrologia Experimental, Departamento de Patologia Basica, Universidade Federal do Parana, Curitiba, PR, BR
  • 2 Departamento de Medicina Interna, Divisao de Nefrologia, Universidade Federal do Parana, Curitiba, PR, BR
  • 3 Programa de Pos-Graduacao em Ciencias da Saude, Pontificia Universidade Catolica do Parana, Curitiba, PR, BR
  • 4 Departamento de Analises Clinicas, Universidade Federal do Parana, Curitiba, PR, BR
Published Article
Faculdade de Medicina / USP
Publication Date
Feb 16, 2021
DOI: 10.6061/clinics/2021/e1821
PMID: 33624705
PMCID: PMC7885853
PubMed Central
  • Original Article


OBJECTIVES: This study aimed to evaluate the potential anti-inflammatory effects of vitamin D supplementation under uremic conditions, both in vivo and in vitro , and its effects on the parameters of mineral metabolism. METHODS: Thirty-two hemodialysis patients were randomly assigned to receive placebo (N=14) or cholecalciferol (N=18) for six months. Serum levels of calcium, phosphate, total alkaline phosphatase, intact parathyroid hormone (iPTH), and vitamin D were measured at baseline and after three and six months. The levels of fibroblast growth factor-23 (FGF-23), interleukin-1β (IL-1β), and high-sensitivity C-reactive protein (hs-CRP) were also measured at baseline and at six months. Human monocytes were used for in vitro experiments and treated with cholecalciferol (150 nM) and uremic serum. Cell viability, reactive oxygen species (ROS) production, and cathelicidin (CAMP) expression were evaluated using the 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide assay, dichloro-dihydro-fluorescein diacetate assay, and real time-quantitative polymerase chain reaction, respectively. RESULTS: Both patient groups were clinically and biochemically similar at baseline. After six months, the levels of vitamin D and iPTH were higher and lower, respectively, in the cholecalciferol group than in the placebo group ( p <0.05). There was no significant difference between the parameters of mineral metabolism, such as IL-1β and hs-CRP levels, in both groups. Treatment with uremic serum lowered the monocyte viability ( p <0.0001) and increased ROS production ( p <0.01) and CAMP expression ( p <0.05); these effects were counterbalanced by cholecalciferol treatment ( p <0.05). CONCLUSIONS: Thus, cholecalciferol supplementation is an efficient strategy to ameliorate hypovitaminosis D in hemodialysis patients, but its beneficial effects on the control of secondary hyperparathyroidism are relatively unclear. Even though cholecalciferol exhibited anti-inflammatory effects in vitro , its short-term supplementation was not effective in improving the inflammatory profile of patients on hemodialysis, as indicated by the IL-1β and hs-CRP levels.

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